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Postpartum Anxiety after Twins

I had never heard of postpartum anxiety until a friend of mine told me she was going to a counseling group after her second child. “Is that the same as postpartum depression?” I asked; but in fact, these two conditions are symptomatically very different. Both are common problems, but studies have shown postpartum anxiety to be even more prevalent than postpartum depression. So what is it? When is it a problem? And how common is it to suffer postpartum anxiety after twins?

postpartum anxiety after twins pin

It’s normal to worry about your kids. But when you’re assigned a ‘high risk’ doctor, scheduled for by-weekly scans, and repeatedly told about the chances of your kids ending up in the NICU, twin pregnancy is inherently a time of worry. Following that, the first year with twins is really tough, and there’s no wonder we are more susceptible to mental health issues.

PostPartum Anxiety after Twins

Post Partum Mood Disorders (PPMD, a term used to group all postpartum conditions, including anxiety) are thought to be triggered by hormonal shifts after childbirth. However, a history of mental health problems, high-stress pregnancy, and premature birth all contribute to the chances of being affected.

The rate of PPMD in mothers of multiples is thought to be around 30%, compared with 10-15% for moms of singleton parents.* 

It’s normal to worry because multiples are commonly premature tiny babies… they need a little more TLC, yet there’s still only one of you. To add to the mix, everyone you bump into at the Grocery store looks at you wide eyed and says ‘How do you do it?“. Although these words are well intentioned, it doesn’t help the overwhelming panic you might feel in your gut on a bad day.

Symptoms of Postpartum Anxiety

“It felt like I had a cannon ball weighing down on my chest the whole time. Little things (accidents, like dropping shopping or burning toast) felt like major incidents. I remember being physically tense, which gave me headaches. I’ve always been a worrier, and my worrying went out of control and I’d have awful ‘daymares’ where I’d convince myself all sorts of awful things would happen to the boys  and my family.” (Sarah, mom of two and postpartum anxiety sufferer)

Postpartum anxiety affects you physically and emotionally. Some common symptoms are:
  • Constant worry and racing thoughts;
  • Feeling or imagining something bad is going to happen;
  • Fidgety behavior and an inability to sit still;
  • Disturbed sleep and eating patterns;
  • Episodes of dizziness, hot flashes, and nausea;

Knowing When to Get Help

This is where I struggle. I am not a doctor person. Partly because I imagine doctors rolling their eyes and calling me a hypochondriac (which I’m sure would never happen), and partly because I’m not a pill popper. I don’t like the idea of someone talking to me for five minutes and sending me on my way with a repeat prescription of drugs I’ll never be able to live without. Plus… it’s normal to feel a bit jumpy, right?

“Women are used to handling things, so they assume it’s all part of new motherhood, white-knuckle it, and push through,” (Margaret Howard, in interview with the Seleni Institute)

Last night I woke from a dream about my daughter being kidnapped. She was being held to ransom and I couldn’t find a way to get to her back. I then spent the next two hours wide awake with visions of the Twins throwing themselves over the half partition at the top of the stairs. I’ve been thinking about this possibility for about two months because they now know how to move furniture and use it to climb on. As the scene plays in my mind I get a sudden physical sensation which washes down through my tightened chest, and as it reaches my stomach I feel like I might vomit. I feel dizzy and disorientated, but all just for a moment… until my brain hits the replay button and it starts all over again. I have been unfortunate to suffer from Vertigo in the past and the sensation is very similar.

postpartum anxiety after twins vertigo

Last year, it was considerably worse, especially when the Twins started to eat solids. Anyone that has seen my kids know they are far from underweight, yet I had all consuming constant panic about what they were eating and when they were eating. Then in November, my daughter had a health scare and I thought I might crumble altogether.

Most people who know me personally see me as the chilled type. I’m efficient yet relaxed and don’t let things get the better of me. On the other hand, I’m sure my husband thinks I’m crazy, but I suppose he gets to see it all. In reality, I’m just like most people, putting on a brave face at times, not for other people, but for myself. Because if I keep my chin up (how very British of me) I can pull myself through to a better place on the other side.

Do I think this is good advice? Not really. I should have gone to see someone with experience in postpartum anxiety last year when I was feeling really overwhelmed with things. I should still probably go and see someone because I haven’t slept properly in months. Note to self… the doctor is not going to roll her eyes and force Xanax down my throat.

What to do if you think you may be experiencing Postpartum anxiety after twins:

“One day I really shouted at Kasper for no reason other than my failing to deal with general 2-year-old nonsense. I was really scared by that, and I called the doctor as soon as I had calmed down and apologized to Kasper. I did a Cognitive Behavioral Therapy course, and the most useful thing I learned was to separate my worries into ‘helpful‘ (would prevent something bad happening) and ‘unhelpful‘ (things I have no control over).

Speak to people. Any people. I am the WORST at this, which is crazy because I talk to the internet all the time. I totally understand the reluctance to visit the doctor, and if you’re not ready to deal with that level of intervention, talk to someone else first. Family, friends, help groups… anyone who is an adult and can give sound advice. As twin moms, we tend to get out less and suffer cabin fever more than our singleton mom friends. So, get them to come to you, and tell them all the obscure thoughts you’re having in the middle of the night. Breaking the seal on saying it out loud might just give you the boost you need to get help.

And there’s alway me… send me an email. I’m a real person you know!

Further Reading on Postpartum anxiety after twins:

Delayed Speech in Toddlers: Qualifying for Early Intervention

We’ve spent the past month or so being assessed for the government funded ‘Early Intervention Program’ for speech and language therapy. Delayed speech in toddlers can be incredibly frustrating for all and is common in twins. Some say twins develop their own language, and this eliminates the desire to communicate with others. Whatever it is… I’d like some progress, and I long for them to call me mama.

delayed speech in toddlers early intervention program

We are now qualified for the Early Intervention Program and ready for our first therapy session next week, so I thought I’d pass on my experience with the assessment process. I outline the criteria that qualified the boys for the program, and what appointment and tests were carried out.

What is the Early Intervention Program?

The Early Intervention Program is for babies and children up to the age of 36months, so if you are genuinely concerned it’s good to be assessed earlier rather than later. The program is free in Arizona, but the cost and qualifying criteria vary across different States. If you’re interested in the criteria for your state, see this table. The program is designed to help with physical, cognitive, social/emotional and communication delays. Each of these is assessed separately… we qualified for help with ‘communication’.

10 Reasons we Qualified for ‘Early Intervention’ at 20months:

  1. The twins do not use any words consistently and with purpose (only babbling);
  2. They used to say ‘mama’ and ‘dada’ months ago and stopped;
  3. They do not use any of their own word like expressions other than ‘da’;
  4. They will not try to copy sounds that I make to them;
  5. They will not respond verbally to the use of their names;
  6. They will not make sounds to try and sing along with songs;
  7. They do not point at objects in a book if asked eg “where is the car?”
  8. They do not point to their body parts when asked eg “where’s your nose?”
  9. They do not go and get a particular toy when asked;
  10. They have not made any language progress for some months;

delayed speech in toddlers assess

The Qualification Process for early intervention

The assessment process usually starts with your pediatrician. You will discuss development at your well check appointments, but if you don’t want to wait until your next check up, just make an appointment to discuss development separately. We talked about moving forward with formal assessment at their 15 month appointment but we thought we’d give it another three months to see if anything changed. On reflection, I would recommend getting the ball rolling as soon as you and your pediatrician notice significant delays, because the Early Intervention assessment process takes time, and it will probably be another two months until you actually start therapy. 

Here’s a summary of the appointments we had before therapy starts:

  • Referral from our pediatrician (they apply for you and you just wait for a call);
  • Paperwork meeting. Someone assigned to our case came to the house to ask questions and fill in a bunch of paperwork. The twins did not have to be present.
  • Developmental evaluation. Two therapists came to our house, one assessed Physical stuff (gross and fine motor skills), one assessed communication and social/emotional development. They first asked me more questions about what they could and couldn’t do, most of which was a repeat of the paperwork meeting. Then the twins were assessed through play and observation. More on how they were assessed below!
  • Goals meeting. We had three lovely ladies at the house for this meeting… a little more paperwork, a few signatures to confirm their place on the program. The aim of the meeting is to agree on targets and frequency of appointments required. We are booked in for two therapy sessions a month for the next six months when we will be reassessed for progress.
  • First therapy session. Our first session is next week, so I’ll keep you posted. There were about two weeks between each of these appointments so you can see it takes a little time to get sorted.

How is delayed speech in toddlers evaluated?

A lot of the assessment is done through questioning of the primary care giver. However, the assessment is carried out by trained therapists and is play based and observational. Here are some of the exercises they carried out:

  • They were given pegs to put into color coordinated holes. This particular toy sprung the pegs back out which the boys found hilarious. This is testing fine motor skills (getting the peg in), communication (by asking them to do it), and social/emotional (do they find things funny?).
  • Wooden stacking blocks. This is one of the staple physical development milestones… can they stack six blocks on top of each other?
  • They were asked to pick out a toy banana from a row of other objects. As suspected, Arthur went straight for whatever he thought the most interesting… a fork.
  • They were asked to wave, high five and clap.
  • They were asked if they would like to have objects before being given them to assess verbal response. 
  • They were prompted with words like ‘uh-oh’ when they dropped something, or ‘dog’ when playing with ours (who found the whole thing very exciting) to see if they would repeat the words.
  • They were read to, pointing out objects in the book and prompted to repeat the word by saying it three times.

Mostly it was just hanging out and observing normal behavior. The boys were busy playing peekaboo, running around and pushing each other on their ride on cars. At the end of the appointment, each area of development is scored. The boys scored excellently for social/emotional development, scraping average for physical, below average for ‘receptive language’ (understanding), and very poor in for ‘expressive language’ (talking).

To qualify for speech and language therapy, an average score is taken for receptive and expressive language. Although the boys’ receptive language was below average, it was not low enough to qualify. However, because their expressive language was so bad, the average came out just low enough to qualify for the program. I was told the boys qualified at the evaluation appointment itself.

delayed speech in toddlers signing

Advice I was given to help progress

At the evaluation appointment, I was aware it would be some time until our first therapy session. I asked for some tips for how to help them while the therapist was there. Here’s what I was recommended:

  • Work on the signs for ‘more’, ‘please’, ‘all done’ and ‘help’. Do it yourself and then move their hands to copy. These words are applicable to meal times and when playing with toys. Parenting.com have a slideshow of common signs, and even give away a flashcard freebie if you’re willing to subscribe to their email list.
  • When you say words, point to the part of your body doing the work to make the sound. If they’ve just pointed at the fan, say ‘fan’, over emphasizing the ‘f’ with your mouth and point at your mouth while you do it. This will help get them focused on watching you, because they may not be looking at your mouth when you talk. A ‘k’ sound may apply more to your throat than your lips for example.
  • Work on one-on-one conversation. Talk to them, wait for a response, talk back. It sounds basic but encouraging them to make any verbal response is the start of communication. 

I’ll be reporting back with more information on delayed speech in toddlers after we’ve had a few therapy sessions. George is getting pretty good at “nah” (no), and he’s still bossing his brother around like he owns the place so I look forward to his verbal commands soon! Wish us luck!

Sleeping Arrangements for Twins – Crib & Room Sharing

I’m a member of many online twin mom groups, and it is often asked… did your twins share a crib? The simple answer is yes, but when it comes down to the nitty gritty, there are many different sleeping arrangements for twins. Whether you’re concerned about safety or practicality, there is a lot to consider. So before you go shopping for cribs, consider how you want those babies to sleep.

 

sleeping arrangements for twins facebook

 

Is it Safe for Twins to Share a Crib?

 

You may have concerns about the safety of your twins while sharing a crib. You often see photos of twins snuggled tightly together while sleeping, after all they were pretty up close and personal in utero. We have a number of those adorable moments captured on camera ourselves, but, generally I felt more comfortable when the twins were close together but not snuggling. In the hospital I had them share a box (that’s pretty much all you can call those plastic tubs) but only for a couple of days because I found they started to wake each other up. Still, I believe having them close to each other helps them stay calm, even today now they’re 20month old.

“Cobedding promotes self-regulation and sleep and decreases crying without apparent increased risk.” (Effect of Cobedding Twins on Coregulation, Infant State, and Twin Safety – JOGNN)

 

Sleeping Arrangements for Twins in a Shared Crib

sleeping arrangements for twins side by side

For the more snuggly orientation, go for a classic side by side set up. I worried about them moving and getting in the way of each other’s breathing, and it was also incredibly difficult to pick one up to feed without jiggling and therefore waking the other. 

sleeping arrangements for twins head to head

I must say, I never tried this one, although it is often recommended as the safest way to co-bed twins. Their heads a close enough to hear each other’s breathing, but faces are clear of legs and accompanying swaddles/sleep sacks.

This is how we had our twins sleeping for the first three months. They have enough space that you can pick them up without waking the other, but they feel close enough to encourage self-regulation. At three months, they became too tall to lay in this position, and they started to rotate in the night and kick each other in the head! So we moved them at that point into their own cribs.

 

Another popular choice for the early days:

Many twin moms choose to use a pack n play with basinet attachments for the first couple months. They are at a good height to reduce bending (especially useful post c-section) and allows separate sleeping space without swallowing the room while they’re in with you. The Graco is particularly popular –> Graco Pack ‘n Play Playard with Twins Bassinet (Amazon affiliate link)

 

Slight Side Note: The Use of Blankets in Cribs

A generation ago, we were all bundled up in blankets, in cribs decorated with padded bumpers, sleeping on our bellies nuzzled up against a cuddly toy. The campaign to encourage moms to sleep babies on their backs and keep them away from smoke (amongst other things) has seen a huge decline in Sudden Infant Death Syndrome (SIDS). But sadly since 2000, deaths classified as ASSB (accidental suffocation and strangulation in bedding) have slightly increased.

The horrific story of Jordan DeRosier and the loss of her 7month old son this week made my stomach wrench and my eyes fill with tears the second I saw her post on Facebook. I can not stress enough the importance of not using blankets in your crib before 12 months. With twins there seems to be even more of a risk that one will get tangled, because there are two blankets and two moving babies. I had mine swaddled for the first couple of months, but once they started to bust out of that swaddle, they only wore sleepsacks.

 

What about co-sleeping with parents?

This is always a delicate subject, because the world is torn between whether its a great idea or a terrible one. Accidents can happen, but at the same time they are so close-by, you are more likely to notice if something is wrong. I honestly don’t know where I stand on the safety factor, all I know is when there is a child in my bed, let alone two, I don’t sleep. They fidget, you get butts in your face, and it’s all round a disaster for mom’s precious sleep.

Having said that, there were times during the first few months when they were sick, or teething, or just outright cranky, and I would bring them into bed for a cuddle to get them to sleep. I found they always rolled into each other and me, and it all became a little congested to feel safe.

“Try putting one baby next to you and the other in a bedside co-sleeper, a crib-like bed that attaches safely to your bed. ” (Dr Sears, Parenting.com)

Many twin moms will find it easier to have one baby on each side of them, making breastfeeding during the night simple. Personally I like to be able to slide out of bed without disturbing them, so on the odd occasion I had them in the bed they went between Daddy and me. But they would always end up smooched into my armpit together, so I never got any sleep!

 

sleeping arrangements for twins cosleep

 

Sleeping Arrangements for Twins is Separate Cribs?

It can be difficult to find the space for two cribs. And you may limited as the arrangement you can create in your new nursery. 

Sleeping Arrangements for Twins Interlocking

This seems to be a popular option, because it’s the most space efficient for smaller rooms. If you do decide to have the cribs touching, do make sure decorative mouldings do not cause a small gap. A fellow Phoenix twin mom brought this to my attention after her 18month old was found hanging from his head after getting stuck in the small gap between the cribs. Luckily, the boy was fine because his Mom found him quickly. It could have ended differently.

Sleeping Arrangements for Twins End to End

Visually, I like end to end… it gives a symmetry to the room that can look adorable. However, if you want to have the cribs touching, just make sure they do actually touch, you may even want to fix them together. Otherwise, spread them apart to create a good sized gap, one that will mean baby will land on the floor rather than get caught on their way down. 

Sleeping Arrangements for Twins middle

This is how we have our cribs arranged. We were really limited with wall space because of the closet, two windows and a door. That left no space for two cribs! Placing cribs along an outside wall is also not advised because babies can get cold at night (whoever came up with that one doesn’t live in Arizona); so if you are trying to reduce contact with the wall, this arrangement is a good shout. Just allow a good gap between the cribs or make sure they’re safely fixed together.

 

sleeping arrangements for twins side by side cribs

 

sleeping arrangements for twins far apart

If you want to reduce the temptation to try and climb from one crib to the other you may choose to just keep those pesky babies as far apart as possible!

 

What about when they move to beds?

Twins have the best incentive to escape their crib… they have a sibling to get to! Once my boys have worked out how to do this, they will be moving into beds, even though it may be earlier than I’d like. If you’re considering your sleeping arrangements for twins in beds or bunks, head over to my design post on beds for shared rooms.

Many parents decide to separate twins into separate rooms when they move into beds, because they just run wild through the night. I’m remaining hopeful that with some perseverance we can work it out… I’ll keep you posted on that one, haha!

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Reflecting on My Infant Feeding Choices

I’m often in awe when I see a Mom in the park, cafe, library (pretty much anywhere) breastfeeding. They have this wondrous way of whipping the baby under their nifty top and popping he/she on the nipple without even a wince, or even a pause in their conversation with friends. Sometimes I catch myself staring, and quickly correct myself so as not to look like a total weirdo, but I honestly can’t get over how easy it seems. I wonder how much these Mom’s struggled at the start, how many times they cried through the pain, or struggled for an hour to get a nipple in their baby’s mouth. Because that was the reality for me… breastfeeding didn’t work out. And although I’m OK with that, I do think my infant feeding choices could have been made with a little more knowledge and preparation under my belt.

infant feeding choices FB

My first born was exclusively breastfed for all of 10 days; by which point I was in tears every time I fed her, I had thrush in my nipples, and was swamped in guilt because I dreaded feeding my own child. I abruptly stopped, and inevitably came down with mastitis, and the whole experience felt like one big disaster. On reflection, I was massively underprepared, I just didn’t realize how hard it would be, and I didn’t have any help on hand to get me through it.

Preparing for Feeding Twins

Having learnt from the experience with my daughter, when I found out I was pregnant with twins, I didn’t really know what to think. I hadn’t managed to successfully breastfeed one baby, how on Earth was I going to manage two? Yet people do manage it, frequently… so why not me? In the build up to the birth, I was recommended a lactation consultant. I couldn’t decide whether I wanted to talk to such an expert; would it create too much pressure to breastfeed when I wasn’t 100% sure if I wanted to myself? If I signed up with a consultant, would she frown upon my decision to formula feed if that’s the way I decided to go? I just wanted the freedom to make my own decision, without pressure from anyone else. On reflection, this was’t a good decision, because the experience I gained with my daughter turned out to be totally irrelevant to my experience with the Twins.

infant feeding choices cs

When the Twins Arrived

The Twins arrived by C-Section at 36wks, and I was all set to get those babes on the boob. What my previous experience hadn’t taught me was that premature babies don’t tend to feed well. While my daughter was a fabulous feeder (it was me that struggled), the Twins wouldn’t latch… in fact they struggled to stay awake long enough to even try. I spent the first three days stripping them naked, putting a wet cloth in their diaper, tickling and pretty much anything the staff and I could come up with, to keep them awake long enough to feed. I found the only thing that worked was to ramp down the air-con in the room at feeding time, probably not recommended when you’re trying to keep a newborn warm.

When I did manage to get them awake, I couldn’t get their mouth open wide enough to stuff that nipple in where it needed to be, so I would grapple for 45mins to get things going. Bearing in mind, newborns need feeding every two hours, I had two of them, and it was taking up to an hour to get them on the boob and another hour to feed… the schedule wasn’t adding up. The babies lost weight, a lot of weight. After three days I was told if the boys didn’t at least plateau, they would have to move to the NICU. Terrified, I turned to formula… even though my milk had just started to come in.

The First Few Months

The World Health Organization (WHO) recommend only breast milk for the first six months. Looking back, I wish I had given pumping a good go, while the boys got to grips with feeding. Unfortunately it’s easy to look back and say what you should or would have done, because you’re no longer sleep deprived and healing from major abdominal surgery.

The first month was a bit of a blur; the boys took 45mins each to bottle feed and I fed them back to back. They fed every three hours, so I had a 1.5hr gap between feeds to sleep during the night. I worked my way through many episodes of Midsummer Murders… I recommend it because each episode is exactly 1.5hrs long and there are a lot of them, so you won’t run out in a hurry. It’s also nostalgic for me, having moved from the UK three years ago. I digress… I don’t remember a lot during that dark month, but I do remember Midsummer Murders.

Things became much easier as the boys began to feed more quickly and were able to lay in a Boppy pillow… I could suddenly feed two babies at the same time, hooray! However, you do miss out on the baby cuddles when you bottle feed two babies at the same time. The snuggly gaze you get from cuddling while feeding can’t be beaten, which is why at night I always fed one at a time. It’s simpler, and more calming for all, despite it taking twice as long.

infant feeding choices twins
Aunty Sarah doing the honors while we’re out shopping!

Feeling Confident in Your Infant Feeding Choices

Although the result may have ended up the same, I do wish I had felt more confident about getting advice and support for feeding choices. At the time it felt like there were only two choices – either I feed both babies on my boob, or I bottle feed them formula. In reality, there are all sorts of choices in between. I could have pumped and bottle fed breastmilk while the boys gained strength; I could have supplemented with formula for weight gain, without giving up on breastmilk altogether. And I kick myself that, despite it being my second attempt, I still didn’t prepare myself properly and feel confident in the decisions I was making. 

Introducing the Happy Family Infant Feeding Platform

You may be familiar with the Happy Family brand, however you may not know they offer free resources and support for parents. If you have questions about breastfeeding, supplementing, bottle feeding or infant nutrition, they’ve got your covered! The Happy Family Feeding Platform has a team of ‘Mama Milk Mentors’ on hand for live chat through their website. These lactation specialists and Cornell-Certified nutritionists are all moms themselves, and are here to support your infant feeding choices. 

Learn more about the Happy Family Infant Feeding Platform –> here.

In addition to chatting in person, the team at Happy Family offer articles on infant nutrition and feeding tips. It really is a fabulous resource to feel more confident about feeding your baby.

Perfecting-the-Basic-Step-of-the-Breastfeeding-_Dance__-The-Latch
Source: Happy Family Infant Feeding Platform (Top Latching Tips)

I have three happy healthy children, and do not preach any one feeding choice. But I would recommend getting advice, support, and feeling confident in the infant feeding choices you make.

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Related Posts:

The Twin Pecking Order: Dominance and Submissiveness in Twins

Despite looking particularly identical recently, the Twins could not be more different on the inside. As their personalities grow, the difference between them becomes more apparent; and it feels inevitable that only one emerges at the top of the twin pecking order. It’s natural as part of the animal kingdom, that there be dominance and submissiveness in twins, isn’t it? But unfortunately for Arthur, he’s at the bottom of the twin pecking order, often literally underneath George’s bottom.

twin pecking order dominance and submissiveness in twins fb

The boys were born at 36wks with only an ounce between them in weight and half an inch in length. This is rare… usually one twin will naturally grow larger than the other, and with twins sharing a placenta this can lead to problems with Twin to Twin Transfusion Syndrome. As the boys continued to grow after birth they continued to amaze their pediatrician by remaining completely identical. By their three month appointment they were exactly, to the ounce and inch, the same size. Maybe it’s mysterious twin personality stuff, maybe it’s George’s love for carbs, but once we broke into solid food, George’s weight took the lead, and with it came his dominance.

Personalities Forming the Twin Pecking Order

Arthur is a very busy chap, inquisitive and adventurous, and always getting himself into trouble. If you hear a crash in the background, 80% of the time it’s Arthur, hence the recent finger chopping incident. George on the other hand is charming and cuddly, and generally gets into less trouble than his brother. That’s until you leave them alone. If left in their play space together I will hear screaming from Arthur and wonder what on Earth is going on. When I investigate I often find George sitting on, lying on, and generally crushing his brother in any way he can. This is an improvement on the biting we used to have, at one point poor Arthur was covered in teeth marks. We’ve had kicking, shoving, and all round bullying… yet you would think butter wouldn’t melt if you saw him in the flesh.

Despite all the brotherly love/abuse, Arthur never retaliates. I’ve never once seen him do the same back, and never see the same bite marks on George. It seems they have worked it out between them… George is the boss, and occasionally he needs to remind his minion of his superior status. So, is this twin pecking order anything to worry about? 

Dominance and Submissiveness in Twins

The twin pecking order is normal and natural, although some cases are more severe than others. It is often advised that twins be separated at school into separate classrooms, to allow each student to flourish and maintain individuality. 

‘The challenge with twins is that you have a dominant and submissive twin… If you keep them together in same classroom, the dominant twin will continue to speak for the other sibling and make decisions.’ (Marie Doyle to Renée M. Grinnell, PsychCentral.com)

twin pecking order dominance and submissiveness in twins sad

A study of Inter-twin Relationships and Mental Health describes three categories of dominance between twins:

1 Physical Dominance:

Classically, the bigger twin is the more physically dominant. It’s basic human nature, and particularly applicable to boys as they hit puberty. It happens often with singleton siblings too… the older is bigger, and enforces him/herself through physical dominance.

2 Psychological Dominance:

This one’s interesting… while boys tend to use physical dominance as they hit puberty, girls tend to use psychological dominance. Enforcing opinions, mannerisms and decisions through manipulation; psychological dominance is the one to worry about. It has been shown that if psychological dominance continues into adulthood, the submissive is more likely to suffer with depression and other psychiatric problems such as anorexia; but it’s not all plain sailing for the dominant either:

‘Psychologically dominant males and females of same-sex twin pairs expressed greater nervousness than did their co-twins.’ (Inter-twin Relationships and Mental Health)

3 Verbal Dominance:

As language develops, it is not uncommon for one twin to talk for the other. The verbally dominant twin may respond to questions directed at their co-twin; and they may ask questions and explain situations for their submissive partner. The submissive can become dependent on this verbal crutch, leading to delays in their own speech development.

‘It has been recorded that twins develop distinct roles within their relationship in which each specializes in a specific set of skills. One of these is speaking.’ (Twin and Triplet Psychology: A Professional Guide to Working with Multiples)

What Causes the Twin Pecking Order?

In the animal kingdom, it is often the physically small, sickly type that naturally becomes the submissive. It seems us humans are not much different:

“Perinatal complications appear to be predictive of submissiveness” (Inter-twin Relationships and Mental Health)

Despite being born of good size, Arthur spent a very short time on oxygen when he was born. He also suffered with reflux more than his brother as a newborn. Could these small differences be the reason he now has to bow down to his brother?

Should Parents Worry?

I have previously talked about Twin Escalation Syndrome, which seems related to finding the twin pecking order. Personally, I’m not too concerned about my boys, I see them as a complimentary pair… Arthur has a glint of the clever mischievous type in his eye, George is the protective bear type. So I see them as a team… the Brains and the Brawn… Pinky & The Brain (please tell me you’ve seen Pinky & the Brain?).

Pinky and the Brain
Source: looneytunes.wikia.com

“Many studies of sibling interactions among twins indicate that twins are asymmetrical in their relationship and enact complementary roles relative to one another.” (Inter-twin Relationships and Mental Health)

We have managed to curb the biting with stern tellings off, but the sitting/crushing continues. Another twin mom told be her identical twins had a sudden role reversal as they hit school age, so we will see how their complementary roles develop!

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Can Twins Feel Each Other’s Pain?

It’s been a while since I posted about telepathic twins and other freaky twin stuff, and it’s time to return to the world of the weird and wonderful. Unfortunately the trigger for this research is an unhappy event… my poor little boy has been in a cast past the elbow these past two weeks, and I’m not entirely sure when he’ll be free of it. He’s coping brilliantly, but I have been surprised how his accident has affected his brother. Is it possible twins feel each other’s pain? 

can twins feel each other's pain

It was bound to happen eventually… our first proper injury. But I wasn’t expecting something so dramatic at such a young age. Poor Arthur at 17months amputated the end of his finger using a chair. Yes, a chair – that can happen, and apparently we are not the first. Does it make me a bad person that hearing another child has lost a finger in this way makes me feel better as a parent? If you’ve ever had a child injure themselves you’ll be familiar with that Matrix-style circular slow-motion phenomenon, as you watch events happening before your eyes, yet you just can’t get there in time to stop it. While playing with George on the grass in the back yard, my attention was away from his twin brother for a moment. He was instantly up on the patio chair, stood, it tipped back with his figures curled over the back… and bam… a finger sandwich between patio chair and concrete. In total panic the missing piece of finger went on ice and the entire family bundled into the mom-wagon and headed for the ER.

We were all hysterical; but between two 17month-olds, a seven year old who’ll melt-down over a paper cut, and a Dad that suffers with anxiety and panic attacks; Mom was left trying to keep it together. But as the situation began to calm, and Arthur was in good hands at the hospital, one of us was still extremely distressed. And it wasn’t Arthur – it was his twin brother George. Was he just feeding off the air of emotions? Was he just wanting attention while we whirled around Arthur? Or is it possible twins can feel each other’s pain? 

Twins claiming they share pain

Identical twins Angela King and Elena Gatt insist twins feel each other’s pain. From accidents, to morning sickness, to operations, they share it all. When Angela had her tonsils removed age 8, her sister was totally unaware and stayed with her grandmother during the operation.

‘Elena screamed at the exact moment they were removed,’ Angela said. ‘Grandma called mum and said there was something wrong with El because she was in a lot of pain.’ (Cindy Tran, Daily Mail)

While Angela happily recovered in hospital, Elena struggled to eat at her grandma’s house, because of her continued pain. They recall a similar story where Elena injured her knee while on vacation. Angela felt a sudden pain in her own knee and called immediately to check her sister was OK. To read more about these two, check out the Daily Mail article.

can twins feel each other's pain mail
Angela King and Elena Gatt. Source: dailymail.co.uk

Sally Keeble and her sister Helen, were always skeptical of stories of twin telepathy and weird connections. However, when Helen fell pregnant, her identical twin sister started to experience morning sickness, 100 miles away. Sally then experienced sever stomach cramping in the middle of the night a few weeks before her sister’s due date. When she called to check on her, sure enough her twin had been experiencing early labor pains. Two weeks later Sally felt excruciating abdominal pain, following by dizziness. She remembered the time it happened because she was in the process of leaving work. When she got home, she had a message that her sister had indeed given birth at that exact time. For more on this tory, head over to the The Guardian.

In Telepathic Twins and Other Freaky Twin Stuff, I tell the story of Gemma and Leanne Houghton and the shared connection that saved Leanne’s life, have a read and see what you think!

Is there any science behind the idea that twins feel each other’s pain? 

Identical twins are created from the same fertilized egg – no-one knows what causes the split, although there are theories. Is it possible that having the same DNA can connect you in such a way that you experience the same sensations at the same time? Despite much anecdotal evidence that suggests twins feel each other’s pain, science continues to find little evidence of such a phenomenon. And there are plenty of twins claiming there is no way this type of connection is possible, because they have been totally unaware when something traumatic has happened to their beloved sibling. However, there is a theory to explain this:

‘Researchers at the University of Indiana have studied thousands of twins and have noticed that the later they divided, the closer they become after birth. So it seems likely that this is the group most likely to experience telepathy’ (David Jones, New Dawn Magazine)

So a twin shouldn’t feel bad that they had no idea their sister was being mugged last night, you may have just been an early egg splitter. Of course, some twins never completely split, creating conjoined twins, and one of the earliest records of how twins feel each other’s pain is that of a pair of conjoined twins separated by an operation just after birth:

‘However far apart we are now we still have one and the same body, so that whatever impression, physical or mental, one of us perceives has its after-effects on the other’ says one of the Corsican Brothers back in 1844. (Benjamin Redford, Live Science)

Historically, the idea that twins feel each other’s pain has been ridiculed by science, and I get it… it’s a pretty wacky idea. In 2010 the Nobel prizewinner Brian Josephson was shunned from speaking at an event he was invited to, after it came to light he had been researching a connection between quantum theory and telepathy. His research was written off as an interest in the paranormal, and it was suggested that fellow physicists would no longer take him seriously. Now, anyone that’s read up on quantum theory will know it is some jaw-droppingly crazy sh*#; yet it is widely accepted enough to teach at school these days. So who knows, maybe telepathy and the idea that twins feel each other’s pain will too one day?

einstein quantum theory
source: flickr.com

My own experience…

When it was time to sew the end of Arthur’s finger on, Daddy took George and Big Sister out to the waiting room to avoid more mass hysteria. It took some time to get sorted, because he was drugged to help keep him still and well… stuff in hospitals just takes forever doesn’t it? As the doctors were busy sewing the finger on, Arthur’s drugs began to wear off, and myself and a very large man were busy using our body weight to hold him down (don’t worry, the pain meds were still working, just not the dopey stuff). My phone starting bleeping with multiple messages that I was not in a position to answer…

“Can we come back yet?”

“What’s going on?”

“George is going mental… I don’t know what’s wrong with him”

We had already spent a number of hours in the hospital and both babies had understandably been a upset, but it was the very moment Arthur was having his finger stitched back on that George went crazy, despite being some distance from the room. Weird right?

That night, we made it home and were all exhausted. We managed to squeeze some chicken nuggets into the littles and off they went to bed. Arthur fell into a deep sleep, exhausted from the days events. George went to sleep but repeatedly woke up through the night, unconsolable unless I held him. All my kids are good sleepers, and I can’t remember the last time I had to get up in the night to go into the boys room. He just wouldn’t settle, and was so sad and miserable I ended up bringing him into bed with me. I am no co-sleeper, even my husband is told to move away when I want to sleep… I’m just not a cuddle sleeper. But George needed love and closeness, he was clearly experiencing some kind of trauma, and whether it was purely emotional was difficult to tell. He was so distressed I honestly considered giving him a dose of Tylenol, because he just seemed to be in pain. I didn’t, and he eventually went to sleep, but I can’t help thinking some kind of Twin Thing was happening.

Poor George has had to come with me to all Arthur’s doctor’s appointments which has been very stressful for him, but I presume he just can’t bear seeing his best bud and partner-in-crime suffer. Whether he’s experiencing physical sensations is impossible to tell at this age, but I look forward to questioning them about it when they’re old enough. For know, I’m just happy he’ll healing… we’re on our third cast and look forward to getting back to normal soon!

can twins feel each other's pain casts

What do you think? Is it possible twins feel each other’s pain?

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Do Identical Twins Have the Same DNA?

This may seem like a simple yes/no question… and the simple answer is ‘yes’. However, in reality it’s more complicated than that, and I’ll do my best to simply explain why. Identical twins, unlike fraternal twins, are natural clones of a single fertilized egg. No-one really knows why it happens, although I delved into some of theories a little while back with ‘Identical Twins: Why does the fertilized egg split?’. Cloning, in theory, creates an exact copy of a genetic blueprint; but is that always the case? Do identical twins have the same DNA? 

do identical twins have the same dna

Crime Case Study:

In 2004, DNA testing brought to trial Dwayne McNair for the assault, abduction and rape of two women in Dorchester. It turned out, however, that Dwayne has an identical twin brother, Dwight McNair. The case fell apart because the DNA examined from the rapist’s semen could not pinpoint one person. 

“Ordinary DNA science, the kind of science that’s used around the world every day in courts to identify people, can’t differentiate between identical twins,” (Prosecuter David Deacon)

However, it was only a matter of time before science caught up with this genetic loop hole. In 2014, prosecutor David Deacon stumbled across ‘massively parallel’ sequencing, the next generation in DNA mapping, successfully tested on identical twins in Germany. By comparing the DNA of the rapist’s semen with the saliva of Dwayne, and his brother Dwight, this new technology shows that Dwayne is 2 billion more times likely to be the rapist than his brother. Those are pretty strong odds.

This is the first time ‘massively parallel’ sequencing has been admitted as evidence in a courtroom anywhere in the world. The defense are trying to dismiss the evidence, mainly on the basis that the lab is comparing semen DNA with saliva DNA. The case is ongoing.

What is DNA?

Depending on when you went to school, you probably learnt a little about the building blocks of DNA and cell division. As as speedy recap:

  • Our cells carry 46 chromosomes (23 from each of our parents) in the cell nucleus;
  • A chromosome is made up of one long strand of DNA;
  • A gene is a section of DNA which corresponds with a particular characteristic;
  • A DNA strand is made up of six smaller molecules – deoxyribose, phosphate, and four different nitrogenous bases (adenine, thymine, cytosine and guanine);
  • These four bases are held together in pairs inside the DNA. There are around 25,000 pairs of bases in every human strand of DNA.
  • The order and combination of these base pairs is a unique blueprint for the human body.
do identical twins have the same DNA? helix diagram
source: getrevising.co.uk

What is DNA Sequencing?

DNA sequencing maps out the pattern of bases inside the DNA. And DNA is very small, so this is a difficult and laborious task:

“The diameter of a DNA molecule is about 2 nanometers. A nanometer is one billionth of a meter. A human hair is 100,000 nanometers across.” (Julie Newton, National Human Genome Research Institute)

DNA sequencing has been slowly improving since it’s development in the 1970s, but it was not created purely to bust the occasional twin criminal. Understanding the natural process of DNA cloning in cell growth is crucial in understanding how mutations occur, leading to diseases such as cancer or heart disease. Sequencing technologies are also busy developing cures for known genetic conditions such as muscular dystrophy, cystic fibrosis and Huntington’s disease. 

do identical twins have the same DNA? sequencing image
Credit: Gerald Barber, Virginia Tech. Source: nist.gov

The sequencing process starts by sorting pieces of DNA into different lengths by using electrodes to make the strands move through a gel. Different lengths move at different speeds, thus separating them. Florescent dyes are then added to copied batches of the different lengths of DNA, and dependent on which dye is detected by the computer, each strand can be identified with a particular base at one end. By identifying many ‘ends’ of smaller pieces of DNA, the whole strand can be slowly mapped together. It’s complex, slow and expensive, but the process is improving all the time.

Why would identical twins have different DNA?

As I said earlier, the simple answer to ‘Do identical twins have the same DNA?’ is yes. As my doctor rather sweetly put it:

“Identical twins happen when a baby likes itself so much it makes a copy.”

do identical twins have the same DNA compare diagram
Source: answersonlin.blogspot.com

In truth, scientists don’t call the ball of cells that splits into two ‘a baby’, but it’s certainly on the way. At this point the cells are all the same, no specialized brain, heart or skin cells. So when the ball of cells divides you really do have an equal, identical copy of the original fertilized egg. But next generation DNA sequencing of identical twins now shows slight differences. It seems no-one’s perfect, and there are occasional copy errors in the cloning process, whether it be early on as the cells are becoming a baby, or whether it’s later as we continually produce new cells to grow. These ‘somatic mutations’ can occur at any point, and nearly all of them would not be physically noticeable… tiny differences in the code that only advanced sequencing can detect.

Somatic mutations we are more familiar with are those that cause cancerous tumors, because this particular mutation causes the cells to copy in overdrive, showing themselves dramatically in the form of a tumor. 

Differences between Identical Twins

Nearly all the physical and personality differences seen between identical twins are not due to cell mutations. Environmental factors such as diet, sleep patterns, exercise and exposure to toxins have ‘epigenetic effects’ on the body, which changes how genes express themselves. 

While the sequence of DNA may not be affected by your environment, the way genes work—called gene expression—can. These structural changes can result in slight changes in gene activity; they also can produce more dramatic changes by switching genes on when they should be off or vice versa. (Duke Magazine, Can Your Environment Change Your DNA?).

Research in 2004 looked at the development of Alzheimer’s in identical twins. Only 40 percent of the time did both twins develop the condition by their late 70s; and in many cases, one did and one didn’t. This is unlikely due to cell mutations, and more likely due to lifestyle differences which have ‘switched on’ or ‘off’ particular parts of their DNA. Both twins start with the same genetic likelihood of developing Alzheimer’s, however whether particular genes are expressed will depend on the environment their body lives within. Not only can epigenetic effects change how identical twins look and behave, these structural changes in gene activity can also be passed on to future generations. 

Despite the majority of differences between identical twins being due to environmental factors, very occasionally there comes a case of identical twins born looking a little different due to a genetic mutation. The majority of somatic mutations occur in cells you would never see or notice. But these identical twins born in the UK in 2015 shocked doctors by expressing different eye and skin color. Amelia and Jasmine are monozygotic twins, meaning they came from a single fertilized egg. Yet, somewhere along the journey something happened to the gene in charge of pigment. This altered DNA, was copied again and again until the girls were born, and now they look strikingly different because if it.

do identical twins have the same DNA? monozygotic twins looks different
source: dailymail.co.uk

So… Do Identical Twins Have the Same DNA?

In essence, yes. Identical twins share the same genetic code because they started with the same recipe. However, if you look closely enough, you’ll find some tiny differences in the sequence due to occasional spontaneous mutations that happen during cell division. In addition, epigenetic effects due to environment, can change how genes are expressed. Once a mutation or structural change has occurred, it will be copied again and again, making it potentially detectable throughout the body, depending on how early it occurred. So to be accurate… no, identical twins do not have [exactly] the same DNA.

Mind blown? I hope so.

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References:

Boeri, D. WBUR News Standard. (2017, March). DNA Testing Can’t Differentiate Between Identical Twins. A New Test Challenges That

Britt, R. Live Science. (2005, July) Identical Twins Not So Identical

Duke Magazine. (2012, August). Big Question: Can your Environment Change Your DNA? 

Genome News Network. How Does DNA Sequencing Work?

Martincorena, I. Campbell, P. Science Magazine (2015, September). Somatic mutation in cancer and normal cells

National Human Genome Research Institute. (2015, December) What is Genetic Sequencing?  

Terrell, M. Quick, B. CNBC (2016, May) Editing our genes to cure — not just treat — disease

Guest Post – A Bumpy Start: Pumping at the NICU

Today is a Twin Pickle first… I’m handing over the blog to someone with far more experience and knowledge on this subject than myself. We were lucky enough to avoid the NICU when I had the Twins at 36wks, but I still didn’t manage to successfully breastfeed. This was partly because I panicked about their weight loss, when preemie’s don’t have much to spare; and partly because I lacked knowledge on preemie babies and pumping. Therefore I’m extremely happy to have Katharina from breastfeedsuccessfully.com offer her expertise, for any moms-to-be or new mums worried about how breastfeeding at the NICU is possible. 

pumping at the NICU fb

 


“Don’t stop pumping the plane! My wife is still boarding for our baby!”, my husband blurted out, while sprinting towards the airport terminal staff, after they had made the final boarding call for our flight. By the time I walked up, the airline staff welcomed me with a chuckle and by saying “Good job pumping, Momma!” We had just spent the first 7 days of our precious baby’s life at the Neonatal Intensive Care Unit (NICU), after being air ambulance to a different city shortly following his birth. Needless to say that my husband and I were excited, exhausted, and apparently we were both suffering from major “Mommy Brain”.    

To this day, I still tear up every time I see a picture of a preemie. We only spent 1 week at the NICU, but other parents spent much, much more time there. If you’re expecting twins, then your doctor may have already mentioned that depending on how early your babies arrive and depending on their birth weight, they may be admitted to the NICU. Even though it probably is not what you’re hoping for, you are already ahead of most expecting moms by facing this possible scenario head on and mentally preparing for it. This way you’ll enter and exit the NICU much stronger and more confidently, and you’ll be able to keep your focus on your sweet babies.

baby going to NICU
Transfer to be air ambulanced to Childrens’ Hospital the night Leon was born

If your goal is to breastfeed your twins, know that premature babies are often too weak to start breastfeeding after birth, and they may be tube or bottle fed at the NICU instead. Therefore, the foundation to successfully breastfeeding your twins later down the road, is to first learn how to pump successfully. Many other moms of twins have done this before, and while there are some challenges to overcome, it’s completely doable!

 “Will I have enough milk for my babies?” is a very common question, especially for moms of twins. It can be easy for people (even well-intending family and friends) to knock your confidence, when it comes to producing enough milk. Your best strategy to silence your inner critic and to create a generous milk supply is to thoroughly understand how milk production works. Breasts create more or less milk, depending on how frequently and efficiently they are emptied. So, the more often and the more thoroughly your breasts are emptied, the more quickly your body will replenish. Usually, it’s your babies’ job to empty your breasts and to tell your body how much milk to produce, but if things start off at the NICU then you’ll take charge of this yourself via pumping. If managed well you can get explosive results.

 

What kind of pump should I get?

While your NICU will provide you with a pump, you may still choose to buy one ahead of time or know where you can rent one in a jiffy, so you are also prepared for pumping at home. If you’re expecting twins, a hospital grade double-pump will cut your pumping time in half, because you’re emptying both breasts at the same time. That’s a huge time saver! When shopping for a pump, pay attention to reviews of other moms about how thoroughly the pump empties their breasts.

Pumps usually have a “Stimulating Phase”, which is a single setting that lightly stimulates your breast to trigger the milk flow. Once the “let down” happens and your milk begins to flow, you’ll switch the pump to “Expression Phase”. In this phase, you’ll be able to choose from several intensity levels. Don’t use the highest level when you first start pumping. Work your way up towards it, so you can get used to the higher settings more slowly. For the first few pumping sessions, start by pumping only one side at a time. You’ll learn how to handle the pump more easily and also have a free hand to massage your breast during pumping. Light massages and compressions can help ease breast engorgement, which is quite common in the early days.  Later on, a pumping bra, will free up your hands, so you can enjoy a little mobility while pumping. By the way, do not do any pumping, while you are still pregnant, because stimulating your breasts towards the end of pregnancy can actually bring on your labor.

baby at the NICU
Leon taking a snooze at the NICU

 

Where will I pump?

During my pregnancy, I always imagined spending the first couple of days of my baby’s life bonding in the privacy in our own hospital room together with my husband, with the occasional doctor, nurse, or close family member checking on us. NICU life is quite different. Your babies will likely be inside an incubator, in a large, open room together with several other babies. Our NICU had approximately 20 babies in the same room, with a nurse to baby ratio of 1:2. You’ll be sharing the room with the NICU staff, the other parents, as well as the visitors of other babies. The only means to create some privacy are mobile wall panels, that you can set up to create a “quiet corner”. Pumping bedside allows you to spend more time with your babies and also gives you an opportunity to ask the nurses for help if needed. If you’re having any difficulties, ask multiple nurses, because each nurse may have a different suggestion or solution. Also, take advantage of the hospital’s lactation consultant and discuss your progress with her as frequently as possible.  

During busy visitor hours, you can seek out the “Mother’s Pumping Room”, which every NICU has. It’s probably not the fanciest of rooms, but it will give you some well-deserved privacy. During the night, you’ll be pumping either at your hospital room or at home. If you’re able to set up your pump beside the bed, you may be able to “rest” a little while pumping in bed. Just use some pillows to prop yourself up and get comfortable.

baby under blue lamp hospital
Catching some rays at the NICU to fight his jaundice

 

How often and how long should I pump?

Due to our delayed transfer to a different hospital, I didn’t get my hands on a pump until almost 16 hours after my son’s birth. Delaying pumping past 6 hours after birth is never recommended, but it goes to show that you can have success with pumping, even when things start out less than perfect. When I was finally handed a pump by a nurse in her early 20s, who undoubtedly had never pumped or breastfed herself, she told me “Here you go. Pump for 10 minutes on each side, every 3 hours”. So, off I went and started pumping, strictly abiding to her instructions. Once my milk came in more heavily, 10 minute pumping sessions weren’t nearly long enough to get the job done, leaving me completely engorged. At the time, I didn’t realize what my breasts should feel like during this stage. I had heard so much about how sore and uncomfortable women’s breasts get, so I figured this must be all part of it. I was so grateful, when a more experienced NICU nurse told me to keep pumping each side until my breasts were empty and felt “soft” again. No more of this 10 minute nonsense! Remember how important emptying your breasts frequently and thoroughly is for your supply? I quickly learnt that pumping more often than every 3 hours and emptying my breasts completely did wonders to my milk supply. So I aimed for more frequent pumping during the day, and stuck with a 3 hour routine during the night. Also, if one breast still feels heavier and lumpy in certain spots after pumping, there is still some milk left. It may indicate plugged ducts. Keep pumping, and massage the lumpy area, starting from the top working down towards the nipple. You may pump quite some time without any milk flow, when all of a sudden the duct unplugs and milk flows full force for a few seconds, until the duct is completely emptied.  

 

Why is no milk coming?

Pumping during the first 3 days, can be mental torture. Sure its physically exhausting, but what’s even more difficult is staring at an empty bottle, session after session. It can be outright disheartening and cause moms to throw in the towel, saying “I literally had no milk!”. I remember panicking over this, too!

Generally, colostrum is produced over the first 3 days, followed by a noticeable increase in milk supply after day 3. That is textbook milk supply, though! If your story is different that’s completely OK. Multiple factors, can trigger delays in milk production, such as being a first time mom, large amounts of IV during labor, medications during labor, traumatic birth, c-section, long pushing stage, delay in pumping, and many more 1. I checked off at least 6 of these factors, which caused my milk to come in quite late. I still stuck to my pumping routine, remained focused, and was eventually able to exclusively feed my son with breastmilk.  Know that under difficult circumstances, it may take over a week or two (even several weeks in severe cases) to slowly build up a full milk supply. If your twins are born quite prematurely, it may mean your breasts missed part of the growth period of late pregnancy, resulting in less milk producing tissue at birth 1. Again, frequent and thorough pumping, will help your breast tissue to continue to grow and develop after birth 1. Once you’ve done the hard work of developing your supply, you’ll reap the reward of watching your twins getting “milk drunk” on momma’s milk. 

 

Almost no milk is coming!

When you finally start seeing a thick drop of colostrum slowly coming out of your nipple and running down the horn of your pump there is a good chance the precious drop will go completely to waste. Why? Because by the time it has made its way from the horn, through the pump’s valve, all the way down the inside of the bottle, it’s likely going to have dried right up. That’s why hand-expressing is usually more effective at this stage. Simply press a spoon or tiny cup tightly against your breast, just below your nipple. Use your other hand to compress and massage from just above and below your areola down towards your nipple. Ask a NICU nurse or a lactation consultant for help with this if you need any. They will also help you feed your colostrum to your babies. Always remember to still pump after hand-expressing to stimulate your production. It’s absolutely fine if no or almost no milk is released during your pumping sessions. You’re simply sending your body a message to start producing milk. Give it some time.

You may see other moms entering the pumping room after you and leaving before you, holding two 8 ounce bottles of milk, filled to the rim, while you’re struggling to create a single ounce. Instead of getting discouraged and being struck down with milk envy, try to remember that this mom has likely spent much more time at the NICU than you. Stay focused on your goal: Building a generous milk supply for your sweet babies.

Once the pump starts to express some milk, you may want to attach the pumping horn to your breast upside down, resulting in the bottle being held upside down as well. This shortens the path your milk has to travel, saving your precious milk right inside the pump’s horn, where you can syringe it out of later on. NICUs carry syringes in various sizes, and you’ll feel incredibly accomplished every time you move up a syringe size, because you’re supply has increased again.

baby leaving NICU
Leaving the Childrens’ Hospital after 7 days to take our baby home

What about supplementing?

While you are working very hard at boosting your milk production, your babies may still need some supplementing in the early days. Trust your NICU staff about when and how much to supplement. It was gut-wrenching for me, when my baby wasn’t getting enough milk and needed to be supplemented. I unnecessarily put myself through the ringer about not having enough milk. It’s completely okay and absolutely necessary in this situation to supplement! Formula or donor milk can be heaven-sent, and you should never feel guilty about having to supplement. 

 

Skin to Skin or Kangaroo Care:

The first time, I walked up to my son at the NICU, I couldn’t help but start crying. I had kept it together pretty well up until that moment, but seeing him inside the incubator, with cords attached all over his tiny body, and feeling that physical barrier between us unhinged something deep inside of me. All I wanted to do was to finally touch him and hold him. Luckily our head nurse was a huge advocate of “skin to skin”. She helped us take him out of his incubator and placed him properly between my breasts, so he could breathe well and so that the cords weren’t getting caught anywhere.

“Skin to skin” is also known as “Kangaroo Care” and has too many wonderful benefits to name them all. Honestly, we probably haven’t even discovered all of the incredible things it does for moms and their babies. Immediate benefits are stabilizing of babies’ breathing, sugar levels, heart rate, and temperature2. It is soothing to babies, and there are suggestions that it improves babies’ sleep cycles. Mothers feel more empowered and needed by their babies. It lessens the stress load and makes new moms more responsive to their babies’ cues. Most amazingly it is proven to increase the prolactin level in mothers, which is the hormone responsible for helping your body make milk2. So, skin to skin is absolutely wonderful for you, your babies, and for boosting your milk supply. A great time for skin to skin is after you’ve fed your babies. Go braless and have your babies wear nothing except their diapers. Be sure to ask the nurses to help you with placing the twins on your chest and placing pillows below & beside your elbows to help you relax your arms. Also, have them place a blanked over your babies backs to keep them warm. Tucking the blanket around your back will also help keeping your babies more securely on your chest. Dad can join in on the fun too, of course!

preemie baby and mom
Skin to Skin with Leon

One last piece of advice: “Be patient with yourself. Be good to yourself. Be gentle with yourself.” This may be one of the more challenging and exhausting situation you’ll ever work through in your life. Don’t allow yourself or anybody around you to guilt you in any way, regardless of the path you choose. Your babies most and foremost need a strong mom. You may be struggling with a certain aspect of pumping or the NICU one day, and the next day you may have the most incredible moment with your babies erasing all the stress around you for a quick moment. Take it one day at a time, and you’ll do a wonderful job at handling pumping, the NICU, and eventually breastfeeding as well. But most importantly you’ll do a wonderful job being there for your sweet babies.

baby and proud dad
On our way home – Dad and Leon at the airport, while mom is pumping

 

References

  1. When will my milk come in? • KellyMom.com. (2016, March 15). Retrieved February 13, 2017, rom http://kellymom.com/ages/newborn/when-will-my-milk-come-in/
  2. Skin-to-skin Contact. (n.d.). Retrieved February 13, 2017, from http://www.lllc.ca/category/faq-categories/skin-skin-contact

 


Katharina Siemens BioI hope you enjoyed our guest…

Katharina Siemens from breastfeedsuccessfully.com gives expecting and new moms the critical knowledge, practical info, and crunchy solutions to meet their breastfeeding goals. 

 


 
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How to Announce Twin Pregnancy : 10 of the Best Twin Reveals

The world went mad this week when Beyonce showed the world how to announce twin pregnancy like an A-Lister. The Carter’s announcement photo shattered the world record for most liked Instagram image of all time, partly because it’s Beyonce, but partly because of photographer Awol Erizku’s unusual set up. People either loved it, hated it or were just generally confused by it. But one thing’s for sure, it got people talking. As I’ve mentioned before, the general public are obsessed with twins, and when we found out I had two buns in the oven, I found it very difficult not to tell everyone I saw! So how can your big reveal make twice the impact?

how to announce twin pregnancy

I never did the big Facebook reveal when I was pregnant with the Twins, I went with the full impact announcement when they were born. There was a lot going when we first found out I was pregnant… I was in a car crash, my father passed away, and then we moved house and State in the second trimester. With a loss in my past adding to my concerns, I was plagued with pregnancy paranoia, so decided to keep quiet on social media. Despite this, plenty of parents-to-be choose to spread the news in all sorts of creative ways, and I certainly love seeing the results.  Here are some of my favorites:

Two Peas in a Pod

two peas twin announcement
source: pinterest.com

For the Mathematician 

math twins
source: parent.com

For the Comedian

morning sickness twin announcement
source: doublethebatch.com

For the Scientist

IVF twin announcement
source: bertolaphotography.com

IVF Success

ivf success twin announcement
source: pinterest.com

For the Surrogate Pregnancy

surrogate pregnancy announcement
source: theirpeasmypod.wordpress.com

For the Poet

twin announcement poem
Source: Etsy.com (LCoOnEtsy)

For the Star Wars Fan

clone wars twin announcement
source: blogs.babycenter.com

For the Dog Lover

dog twin announcement
source: Pinterest

For the Boy/Girl Reveal

gender reveal twins
source: pinterest

 

I hope you enjoyed these as much as I did. And if you’re here looking for inspiration for your own twin announcement, congratulations!

twin-pickle-signature

Beds in Shared Rooms: What are my Options?

We’re a few months off yet, but I can’t help browse bedroom ideas for the Twins, for when they move to their big boy room later in the year. As soon as they start climbing out of their cribs, trying to get to one another, it’s time to move to proper beds. This is sure to happen earlier than it did with their sister (the temptation of each other is too much), and it’s just a little bit terrifying. I’ve always liked the idea of keeping them together, and it’s what we planned when we bought our house at 20wks pregnant. The room they will be moving to has built in closets, so my main concern is the beds. What are the options for beds in shared rooms? I intend to find out, and start designing my big boys’ room… I am more than excited!

beds in shared rooms fb

Beds in Shared Rooms: Bunk Beds

The obvious answer to beds in shared rooms is the classic bunk option. I had bunk/cabin beds as a kid and sleeping on the top is so much fun. It feels like your own little den!

Pros of Bunk Beds:

  • Space saving;
  • Sleeping on top is awesome;
  • You can come up with fun ways of climbing up and down;

Cons of Bunk Beds:

  • Sleeping on the bottom is generally considered inferior to the top… cue arguments;
  • Young children may not be safe up top;
  • Changing sheets on the top is not fun;
andrew-howard-kids-bedroom
source: housebeautiful.com

You’ve got to love the bunks in this Florida home finished by interior designer Andrew Howard. That slide!

 

Beds in Shared Rooms: Corner Junction Beds

Fitting the beds neatly into the corner is an idea I am very fond of. I like the idea of the boys’ telling each other stories at night, their heads close enough to hear a whisper but without being in direct eye contact.

Pottery Barn Beldon Set
source: potterybarnkids.com

This traditionally styled Belden Bedroom Set by Pottery Barn Kids is perfect. However, the $2000+ price tag (without mattresses) may be a little steep for some. Still, I love the layout and the storage drawers below, and I am confident in the quality of Pottery Barn products.

Pros of Corner Junction Beds:

  • Bedtime stories made easy;
  • The corner junction creates a handy shelf;
  • Everyone is close to the ground;

Cons of Corner Junction Beds:

  • Your room has to be deep enough for the length of the bed and the corner unit;
  • Is anyone else seeing that pointy corner right next to the pillows? Paranoid Mom?

If you love this look and enjoy a bit of DIY there is plenty of inspiration out there to get the power tools excited. Take a look at Ana White’s ‘Corner Hutch Plans’, it’s certainly inspiring me… I love a project!

 

Beds in Shared Rooms: End to End

If you’ve got the length on one wall, there’s something very sweet about end to end beds. If the Twins are getting along they can lay pillow to pillow, and when they’ve had a little sibling feud they can just swap to the other end.

Pros of End to End:

  • Siblings can choose to be close or not;
  • Everyone is close to the ground;

Cons of End to End:

  • Without a headboard there could be pillow breach in the middle;
  • Many bedrooms will not be long enough for this layout;
ends to ends beds
source: blog.elle.fr

 

Beds in Shared Rooms: Interlocking

To squeeze the corner beds into a slightly smaller space, there are a number of options to interlock them. You can overlap an upper bunk, allowing the lower bed more freedom than a traditional bunk. You can also just raise up enough to create a headboard and some lower storage as shown below.

overlap corner beds
source: mommodesign.com

The cute decor in this room is the work of Barcelona based designer Dijous. I recommend checking them out for everything adorable.

Pros of Interlocking Beds:

  • Relatively space saving;
  • Would work at any height;

Cons of Interlocking Beds:

  • One bed could end up superior to the other;
  • Changing sheets could be awkward;

 

Beds in Shared Rooms: Traditional Twin Beds

Of course there’s the obvious solution of buying two twin beds and placing them on opposite sides of the room. Don’t knock it, sometimes simple is best.

Pros of Traditional Twin Beds:

  • Plenty of choice (no DIY required);
  • Feeling of ownership and privacy;

Cons of Traditional Twin Beds:

  • Can look like a dormitory;
  • Direct eye contact may not help littles to sleep;
twin beds cabin
source: thelittlehermitage.tumblr.com

This cabin’s traditional iron beds are just wonderful. They fit the room perfectly and I can see a long bedroom story taking place in that wicker chair. 

Where to go from here…

I can’t wait to get stuck into the design of the boys room and will keep you up to date on it’s progress. Once I’ve made a decision about the layout and position of the beds, I know the rest will just fall into place. My biggest problem is the boys will likely be very young (pre 2yrs) when they move into their big boy room so safety is a major factor. I also want to make it fun, because if you can’t have fun with a kids room, where can you?

To be continued… do give me your thoughts on what I should do, I’d love the blog to help shape the boys’ new room!

twin-pickle-signature

 
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